In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.

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Development and validation of brief measures of positive and negative affect: The PANAS scales.

XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Introduction 1. Woman's Place in Man's Life Cycle 2. Images of Relationship 3. Concepts of Self and Morality 4. Crisis and Transition 5. Women's Rights and Women's Judgment 6. Visions of Maturity References Index of Study Participants General Index

In a Different Voice. Psychological Theory and Women’s Development. Cambridge, MA (Harvard University Press) 1982.

Attachment--and loss.

Background 
The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.
Objectives 
This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.
Data Extraction 
Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.
Results 
Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).
Conclusions 
The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.

Please see later in the article for the Editors' Summary

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Social Relationships and Mortality Risk: A Meta-analytic Review

This research aimed to chart the trajectories of functional status in old age in Japan and to assess how self-rated health and cognitive functioning differentiate these trajectories and account for interpersonal differences. Data came from a 5-wave panel study of a national sample of 2,200 Japanese older adults between 1987 and 1999. The sample as a whole showed an accelerated increase in functional limitations with age. approximated by a quadratic function. More important, 3 major trajectories of functional change were identified: (a) minimal functional decrement, (b) early onset of functional impairment. and (c) late onset of functional impairment. These findings may serve as useful benchmarks for observations derived from other developed nations.

Changes in functional status among older adults in Japan: successful and usual aging.

The purpose of this study is twofold: to estimate the prevalence of depressive symptoms among older adults in four culturally diverse groups (white Americans, black Americans, Japanese, Taiwanese), and to assess whether there are cross-cultural variations in the way depressive symptoms are manifest. Data from three recent nationwide surveys in the United States, Japan, and Taiwan reveal that the lowest overall levels of depressive symptoms are found among Japanese elderly, followed by Taiwanese, white Americans, and black Americans respectively. Based on previous cross-cultural research, it was hypothesized that the Japanese tend to express depressive symptoms as interpersonal complaints, whereas Taiwanese are more likely to manifest somatic symptoms. In contrast, Americans were expected to express depressive symptoms in the form of depressed cognitions. The findings failed to support these hypotheses. Instead, older Americans tended to have higher scores than Orientals on all three depressive symptom clusters.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1041610292001261

Cross-cultural variations in depressive symptoms in later life.

The purpose of this study is to see whether older adults who lost a parent early in life are more vulnerable to the effects of recent stressful events than elderly people who were raised in an intact home. Data from a nationwide longitudinal survey of older adults provide support for this view. The findings indicate that the combined effects of early parental loss and recent stressful events are associated with a decline over time in global self-rated health, as well as the number of chronic and acute conditions. In contrast, significant effects failed to emerge with functional disability. This study contributes to the literature by suggesting that only certain kinds of recent events (i.e., stressors arising in highly valued roles) act in concert with early parental loss to compromise health in late life.

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Early Parental Loss, Recent Life Events, and Changes in Health among Older Adults:

Religious individuals are more likely to engage in healthy practices, including using preventive services; however, the underlying mechanisms have not been adequately explored. To begin addressing this, the current study examines the association between religious attendance, four aspects of congregational support, two health-related religious beliefs, and the use of preventive services (cholesterol screening, flu shot, and colonoscopy) among a national sample of Presbyterian adults (n = 1,076). The findings show that two aspects of congregational support are relevant to these types of behavioral health. First, church-based health activities are significantly related to the use of cholesterol screenings and flu shots (OR = 1.13, P < .05; OR = 1.10, P < .05, respectively). Second, discussing health-related issues with fellow church members is also significantly associated with reporting a cholesterol screening (OR = 1.15, P < .05), as well as moderately predictive of colonoscopy use (OR = 1.10, P < .10). Neither of the religious beliefs related to health, such as the God locus of health control scale or beliefs about the sanctity of the body, are related to preventive service use in this population. Although attendance is predictive of service use in unadjusted models, the association appears to be explained by age rather than by the congregational or belief variables. These findings contribute to a more nuanced understanding of the various ways in which religion might impact health behaviors and may also help to shape and refine interventions designed to improve individual well-being.

Religion and preventive service use: do congregational support and religious beliefs explain the relationship between attendance and utilization?

The primary purpose of this study was to determine if the literature on stress and coping could be useful for studying patterns of physician utilization among older adults. It was hypothesized that elderly people with strong social support systems would be less likely to visit a physician in times of high stress than would older adults who receive less social support. This hypothesis was partially confirmed by the data. The second goal of this study was to determine whether or not locus of control beliefs buffer the effects of stress on physician use. The data suggest that elderly persons with internal locus of control beliefs make fewer visits to the doctor's office in times of high stress than do those individuals with an external locus of control orientation. It should be noted that this study did not assess changes in physician use through time and that information on stress was gathered 18 months prior to the gathering of information on physician utilization.

Neal Krause

Papers

Changes in functional status among older adults in Japan: successful and usual aging.

Cross-cultural variations in depressive symptoms in later life.

Early Parental Loss, Recent Life Events, and Changes in Health among Older Adults:

Religion and preventive service use: do congregational support and religious beliefs explain the relationship between attendance and utilization?

Stressful life events and physician utilization.